To conduct a definitive trial that will determine if IPTp with with dihydroartemisinin-piperaquine (IPRp-DP), either alone or combined with azithromycin (AZ), is a superior efficacious and safe alternative to the existing strategy of IPTp with sulphadoxine-pyrimethamine (SP) for controlling malaria and reducing adverse pregnancy outcomes in areas with high malaria transmission and high SP resistance in East and Southern Africa.

Summary of work

We are undertaking a multi-national, individually-randomized, 3-arm, superiority trial comparing the efficacy, safety and tolerance of IPTp-SP (control) versus IPTp-DP, alone or combined with azithromycin) to reduce the adverse effects of malaria and curable STIs/RTIs in 10 sites in high SP resistance areas in Kenya, Malawi, and Tanzania. The project includes cardiac monitoring for safety, nested studies of antimalarial drug resistance and macrolide resistance, the impact of SP and AZ on vaginal and intestinal microbiota, and health economics, feasibility and acceptability components.

It also includes four African PhD-studentships and a Post-Doctoral fellowship.

Funders

This project is part of the EDCTP2 programme supported by the European Union and also funded by the Joint Global Health Trials (MRC, Wellcome Trust, and DFID)